Laserfiche WebLink
ORIGINALSTATE OF CALIFORNIA Do not fIu in <br /> THE RESOURCES AGENCY <br /> kii <br /> le with PWR DEPARTMENT OF WATER RESOURCES NO. 216097 <br /> Iof Intent No WATER WELL DRMLERS REPORT stat, Wel, No <br /> innt No or Date Other Well No Q <br /> 1) OWNER Name C d 2A 1111 11ML,agivi tC X r c r, (12) WELL LOG Total dee 1tl 5 f Depth of completed well-1-8-0—ft <br /> Address 2"Go P o iy e 1 1 St fmm ft to ft Formation (Descnbe by color character sue or irtaterial l <br /> tty _ Emeryville CA Zip 94508 0 - 10 Fine sand <br /> 2) LOCATION OF WELL (See instructions) 10 - 32 Slue clay <br /> County _ _ San_l o a Cil it owners V-ell Number P-6 A 32 - 4 8 Brown s i l t y c l a y <br /> ill address tf different fmm above O f f Sonora St , Stockton 48 - 1 2 5 Blue C 1 a� <br /> m riship 1 1'1 Range 6E Sectio 1 2 5 - 1 3 8 B l u e c l a y'� fS a n <br /> Dutamu from utieb roads narlruads fences etc 138 - 1 5 5 B 1 12.e'� c l a <br /> 165 - 185 Blue cj'ay c4(arse sand <br /> (3) TYPE OF WORK � <br /> New Well n Deepening ❑ ti <br /> See map attached Reconstruction ❑ <br /> Reconditioning ❑ _ - ' <br /> Horizontal Well ❑ `y♦ - ^ <br /> Destruction ❑ (Describe <br /> destruction matenals and j v <br /> procedures m Item 12,Y - 'i- <br /> (4) PROPOSED USS <br /> Domestic _ ❑ <br /> Imgation �� ♦ ❑ <br /> Industrial ❑ -- <br /> Test Well ❑ - <br /> Stock ♦ ❑< <br /> Municipal ) ❑ <br /> WELL LOCATION SKETCH Othen14 O n l t O r 2 n gC5 - <br /> i) EQUIPMENT (6) GRAVEL PACK - <br /> Rotary a Rei erre C Yes:fl: No ❑ Size - <br /> able C kir ❑ Diameter of bore <br /> ''Lt - <br /> ther C3 Bucket ❑ Packed fmm_�1 i_L_u�to. 1 8 0 -ft - <br /> (7) CASING INSTALLED (8) PERFORATIONS.. - <br /> Steel ❑ Plastid: Concrete [} Type of perforation,ar size of screen _From To Dia Gage or From - To Slot - <br /> ft ft m Wall ft ft size - <br /> 0 180 2t(` 42 40 170 ISO 20 - <br /> 1-7 <br /> (9) WELL SEAL 1 6 5 _ <br /> Was surface sanitary seal pmvided' Yes O-C No ❑ If yes to depth__ ft <br /> "ere strata sealed against pollution" Yes ❑ ho ❑ Intery _.._ft - - - <br /> Method of seahn 11 C—re t o b e n t o n i t e Work started 19 Complet -I9 <br /> (10) WATER LEVELS WELL DRILLER'S STATEMENT <br /> tpth of first water rf know �� 7,,6iriuell Was 1 under my iuriydictio this rt it true to the ben of my <br /> 'tandmrC level after well completi 'kna&redge a of <br /> (11) WELL TESTS SlcNsii <br /> Was well test made' Yes [ No [�Mf yes by whom?' r I - (Well Dnlle <br />�ype of test Pump (] Bader © -.� Air _ " t� NkW - I a m O n f,O D r i l l r I n C <br /> epth to water at start of test ft At Fria of t R -4 f (Person. firm or corporation) (Typed or printed) <br /> rge eat/roan after hours Wates eir{�ea - 4dd <br /> 7� Citi, .2 d r o , C'A zi <br />&,L::�In. <br /> lanalysis made? Yes ❑ No 9 If yes by whor`e` -'-- Palo p`�73 It., made? Yea 0 No ['# If ves, attach copXKo� rep�'t�.7 rss T,a enae No. 5 1 2 4 0 6 - _Date of this repo <br /> t?WR 188 (REV 7 76) IF ADDITIONAL SPACE 15 N EXCONSECUTIVELY NUMBERED FORM �,jS <br />